Low vitamin D, but not tobacco use or high BMI, is associated with long-term disability progression in multiple sclerosis.

Autor: Wesnes K; Department of Clinical Medicine, University of Bergen, Bergen, Norway; Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Bergen, Norway; Department of Neurology, St. Olav's University Hospital, Trondheim, Norway. Electronic address: kristin.wesnes@uib.no., Myhr KM; Department of Clinical Medicine, University of Bergen, Bergen, Norway; Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Bergen, Norway., Riise T; Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Bergen, Norway; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway., Kvistad SS; Department of Clinical Medicine, University of Bergen, Bergen, Norway; Department of Immunology and Transfusion medicine, Haukeland University Hospital, Bergen, Norway., Torkildsen Ø; Department of Clinical Medicine, University of Bergen, Bergen, Norway; Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Bergen, Norway., Wergeland S; Neuro-SysMed, Department of Neurology, Haukeland University Hospital, Bergen, Norway; Norwegian Multiple Sclerosis Competence Center, Department of Neurology, Haukeland University Hospital, Bergen, Norway., Holmøy T; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Neurology, Akershus University Hospital, Lørenskog, Norway., Midgard R; Department of Neurology, Molde Hospital, Molde, Norway., Bru A; Department of Neurology, Stavanger University Hospital, Stavanger, Norway., Edland A; Department of Neurology, Vestre Viken Hospital Trust, Drammen, Norway., Eikeland R; Department of Neurology and Department of Paediatrics, Sørlandet Hospital Trust, Arendal, Norway., Gosal S; Department of Neurology, Østfold Hospital Kalnes, Grålum, Norway., Harbo HF; Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Neurology, Oslo University Hospital Ullevaal, Oslo, Norway., Kleveland G; Department of Neurology, Innlandet Hospital Lillehammer, Lillehammer, Norway., Sørenes YS; Department of Neurology, Haugesund Hospital, Haugesund, Norway., Øksendal N; Department of Neurology, Nordland hospital trust, Bodø, Norway., Bjørnevik K; Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.
Jazyk: angličtina
Zdroj: Multiple sclerosis and related disorders [Mult Scler Relat Disord] 2021 May; Vol. 50, pp. 102801. Date of Electronic Publication: 2021 Jan 28.
DOI: 10.1016/j.msard.2021.102801
Abstrakt: Background: Low vitamin D levels, tobacco use and high body mass index (BMI) have been linked to adverse disease outcomes in multiple sclerosis (MS), but their influence on long-term disability progression remains unclear. Therefore, we explored whether these modifiable lifestyle factors were associated with 10-year clinical disability progression in patients with MS.
Methods: In this prospective study, a cohort of 88 patients with relapsing-remitting MS completed a randomized controlled study on ω-3 fatty acids between 2004 and 2008. During 24 months, serum 25-hydroxyvitamin D (25(OH)D), serum cotinine (nicotine metabolite), and BMI were repeatedly measured. In 2017, a follow-up study was conducted among 80 of the participants, including disability assessment by the Expanded Disability Status Scale (EDSS). Linear regression was used to explore associations between the lifestyle factors and the EDSS change over 10 years.
Results: Higher seasonally adjusted 25(OH)D levels were associated with lower 10-year EDSS progression (change in EDSS per 1 SD increase in 25(OH)D in a model adjusted for sex, age and baseline EDSS: -0.45 point, 95% CI: -0.75 to -0.16, p=0.003). Further adjustments for potential confounders related to lifestyle and disease status gave similar results. The association was mainly driven by low 25(OH)D levels during spring, as well as seasonally adjusted levels below 80 nmol/L. No clear association was found for BMI and cotinine.
Conclusion: Lower 25(OH)D levels, but apparently not tobacco use or higher BMI, were significantly associated with worse long-term disability progression in MS.
(Copyright © 2021. Published by Elsevier B.V.)
Databáze: MEDLINE
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